Provider Demographics
NPI:1750993168
Name:PROPEL PSYCHOTHERAPY, PLLC
Entity type:Organization
Organization Name:PROPEL PSYCHOTHERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:GREENWALD
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:240-988-5631
Mailing Address - Street 1:332 S MICHIGAN AVE
Mailing Address - Street 2:LOWER LEVEL - P807
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60604
Mailing Address - Country:US
Mailing Address - Phone:240-988-5631
Mailing Address - Fax:
Practice Address - Street 1:332 S MICHIGAN AVE
Practice Address - Street 2:LOWER LEVEL - P807
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60604
Practice Address - Country:US
Practice Address - Phone:240-988-5631
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-18
Last Update Date:2020-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health